Evaluate the Reconstruction of Digital Nerve Defects in Humans Using an Implanted Silk Nerve Guide

NCT ID: NCT03673449

Last Updated: 2020-03-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-22

Study Completion Date

2021-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The goal of this study is to ascertain the feasibility and safety of the procedure using SilkBridge - a biocompatible silk fibroin-based scaffold - for the regeneration of sensory nerve fibres and follow it up together with the reinnervation of the target organs (sensory receptors in the skin).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This is a pre-market, monocentre, first-in-human pilot on adult patients with digital nerve defects. Category C clinical trial, medical devices. The study will be performed in Switzerland.

SilkBridge is a biocompatible silk fibroin-based scaffold, which recruits the patients' own cells to remodel or regenerate the nerve, without pre-seeding of the scaffold nor biological/chemical treatments.

SilkBridge will provide surgeons with an implant with unique features, such as easy suturability, full biocompatibility and specific biomimetic properties that enhance cells adhesion and integration of the device with the surrounding tissue.

The study will have a 12 months and 1 week duration per patient, including the follow-up period, and with an expected enrollment period of 15 months.

The study will evaluate 15 adult patients, aged 18-65 years, diagnosed with digital nerve defects (\> 5 mm gap) in whom surgical repair may not allow direct suture.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Peripheral Nerve Injury Digital Nerve Hand

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NA

Intervention Model

SINGLE_GROUP

Open Label Monocentre Study
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

SilkBridge treatment

Surgery for digital nerve reconstruction with SilkBridge

Group Type EXPERIMENTAL

SilkBridge

Intervention Type DEVICE

SilkBridge is a biocompatible silk fibroin-based scaffold, which recruits the patients' own cells to remodel or regenerate the nerve, without pre-seeding of the scaffold nor biological/chemical treatments.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

SilkBridge

SilkBridge is a biocompatible silk fibroin-based scaffold, which recruits the patients' own cells to remodel or regenerate the nerve, without pre-seeding of the scaffold nor biological/chemical treatments.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* male \& female patients between 18 and 65 years of age
* a traumatic injury or a post-traumatic neuroma of a digital nerve on the palmar side of the hand, between the metacarpophalangeal joint and the distal interphalangeal joint
* single lesion per finger
* nerve defect of \>5mm
* nerve treatment initiated within 24 months after nerve injury
* signed informed consent

Exclusion Criteria

* disorders known to affect the peripheral nervous system, such as, but not only, diabetes mellitus, chronic heavy alcohol use, or toxic nerve lesions, or any polyneuropathy
* an additional injury that could compromise nerve regeneration
* clinically significant (as defined by the investigator) renal, hepatic, cardiac, endocrine, metabolic, hematologic, autoimmune, or any systemic disease, which may make implementation/interpretation of the protocol or results difficult
* previous conditions of the hand that could affect the healing of the actual nerve injury
* complete amputation injury
* extensive crush injury
* grossly contaminated wound
* receiving immunosuppressive or antineoplastic agents within 30 days prior to the enrolment
* known to be HIV positive
* known pregnant and lactating females
* participated in another clinical investigation using an investigational new drug or device (or in the present study) within 30 days prior to enrolment into this investigation
* uncooperative or unsuitable, e.g. language problems or a suspicion to be unable to attend follow up appointments, for completion of the investigation
* absence of a healthy opposite finger
* suspected allergy to silk
* need of emergency surgery (within 24 hours from injury)
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Silk Biomaterials srl

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Maurizio Calcagni, MD

Role: PRINCIPAL_INVESTIGATOR

Klinik für Plastische Chirurgie und Handchirurgie - UniversitätsSpital Zürich

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Klinik für Plastische Chirurgie und Handchirurgie - UniversitätsSpital Zürich

Zurich, , Switzerland

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Switzerland

References

Explore related publications, articles, or registry entries linked to this study.

Faroni A, Mobasseri SA, Kingham PJ, Reid AJ. Peripheral nerve regeneration: experimental strategies and future perspectives. Adv Drug Deliv Rev. 2015 Mar;82-83:160-7. doi: 10.1016/j.addr.2014.11.010. Epub 2014 Nov 14.

Reference Type BACKGROUND
PMID: 25446133 (View on PubMed)

Konofaos P, Ver Halen JP. Nerve repair by means of tubulization: past, present, future. J Reconstr Microsurg. 2013 Mar;29(3):149-64. doi: 10.1055/s-0032-1333316. Epub 2013 Jan 9.

Reference Type BACKGROUND
PMID: 23303520 (View on PubMed)

Wieringa PA, Goncalves de Pinho AR, Micera S, van Wezel RJA, Moroni L. Biomimetic Architectures for Peripheral Nerve Repair: A Review of Biofabrication Strategies. Adv Healthc Mater. 2018 Apr;7(8):e1701164. doi: 10.1002/adhm.201701164. Epub 2018 Jan 19.

Reference Type BACKGROUND
PMID: 29349931 (View on PubMed)

Ichihara S, Inada Y, Nakamura T. Artificial nerve tubes and their application for repair of peripheral nerve injury: an update of current concepts. Injury. 2008 Oct;39 Suppl 4:29-39. doi: 10.1016/j.injury.2008.08.029.

Reference Type BACKGROUND
PMID: 18804584 (View on PubMed)

Pfister LA, Papaloizos M, Merkle HP, Gander B. Nerve conduits and growth factor delivery in peripheral nerve repair. J Peripher Nerv Syst. 2007 Jun;12(2):65-82. doi: 10.1111/j.1529-8027.2007.00125.x.

Reference Type BACKGROUND
PMID: 17565531 (View on PubMed)

Daly W, Yao L, Zeugolis D, Windebank A, Pandit A. A biomaterials approach to peripheral nerve regeneration: bridging the peripheral nerve gap and enhancing functional recovery. J R Soc Interface. 2012 Feb 7;9(67):202-21. doi: 10.1098/rsif.2011.0438. Epub 2011 Nov 16.

Reference Type BACKGROUND
PMID: 22090283 (View on PubMed)

Meek MF, Varejao AS, Geuna S. Use of skeletal muscle tissue in peripheral nerve repair: review of the literature. Tissue Eng. 2004 Jul-Aug;10(7-8):1027-36. doi: 10.1089/ten.2004.10.1027.

Reference Type BACKGROUND
PMID: 15363160 (View on PubMed)

Vepari C, Kaplan DL. Silk as a Biomaterial. Prog Polym Sci. 2007;32(8-9):991-1007. doi: 10.1016/j.progpolymsci.2007.05.013.

Reference Type BACKGROUND
PMID: 19543442 (View on PubMed)

Thurber AE, Omenetto FG, Kaplan DL. In vivo bioresponses to silk proteins. Biomaterials. 2015 Dec;71:145-157. doi: 10.1016/j.biomaterials.2015.08.039. Epub 2015 Aug 20.

Reference Type BACKGROUND
PMID: 26322725 (View on PubMed)

De Vita R, Buccheri EM, Pozzi M, Zoccali G. Direct to implant breast reconstruction by using SERI, preliminary report. J Exp Clin Cancer Res. 2014 Nov 25;33(1):78. doi: 10.1186/s13046-014-0078-5.

Reference Type BACKGROUND
PMID: 25422034 (View on PubMed)

Lee JH, Lee JS, Kim DK, Park CH, Lee HR. Clinical outcomes of silk patch in acute tympanic membrane perforation. Clin Exp Otorhinolaryngol. 2015 Jun;8(2):117-22. doi: 10.3342/ceo.2015.8.2.117. Epub 2015 May 13.

Reference Type BACKGROUND
PMID: 26045909 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

SB_DND-01/2018

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Study of Nerve Injuries and Physical Exercise
NCT06846788 NOT_YET_RECRUITING NA